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Comparative Study
. 2021 Nov;46(6):1286-1289.
doi: 10.1111/coa.13831. Epub 2021 Jul 21.

Comparing ultrasound assessment of thyroid nodules using BTA U classification and ACR TIRADS measured against histopathological diagnosis

Simon McClean  1 , Eugene Omakobia  2 , R James A England  3
Affiliations
Comparative Study

Comparing ultrasound assessment of thyroid nodules using BTA U classification and ACR TIRADS measured against histopathological diagnosis

Simon McClean et al. Clin Otolaryngol. 2021 Nov.

Abstract

Introduction: The British Thyroid Association (BTA) recommends ultrasound assessment of thyroid nodules using the U classification. The American College of Radiologists (ACR) recommend assessment with the Thyroid Imaging Reporting and Data System (TIRADS). We conduct the first UK study to compare these two systems.

Methods: Ultrasound (US) reports of patients who underwent surgical excision of thyroid nodules over a 10-year period in one UK centre were reviewed. US findings were collected, and the classifications were retrospectively applied. The systems were compared to histopathological diagnosis.

Results: 308 nodules in 296 patients are included. 135 nodules (43.8%) were malignant. U classification showed sensitivity of 88.1% in recommending FNA, significantly higher than TIRADS at 73.3% (p = .0002). The U classification showed specificity of 41.6%, significantly lower than TIRADS at 64.2% (p=<0.0001). PPV between classifications at equivalent levels showed no significant difference at U3/TR-3 (p=.81), U4/TR-4 (p=.30) or U5/TR-5 (p=.90).

Discussion: Classification systems enable risk stratification of potentially malignant thyroid nodules. This study shows BTA U classification has a higher sensitivity but lower specificity than TIRADS.

Keywords: Data Systems; Neoplasms; Retrospective Studies; Thyroid Gland; Thyroid Nodule; Ultrasonography; United Kingdom.

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References

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